An interview with Dr. Paul Farmer conducted by the United Nations Girls' Education Initiative (UNGEI)

An inspiration to many, you have delivered health solutions to some of the poorest communities in the world. As UN Deputy Special Envoy for Haiti, a doctor, and a father, what is your message to policy makers and donors about education – especially girl’s education?

Education is central to any kind of meaningful development and I think that is true whether we look at it from the perspective of a country, a village, a town, or a family. Education is key, and girls’ education is about the best investment we can make to promote the development goals that we all share.

One of the problems in development work is that we have competing priorities within a fairly small list. We need to say there are a dozen really key interventions to make in country X or in setting X and to know that girls’ education is always going to be on that shortlist. Whether we are talking about the desire to improve health outcomes, or educational outcomes directly, girls’ education is still a great investment. So even as a doctor, for example, one of the best ways that you can promote the health of your patients in general, and the health of the populations, is to invest in girls’ education.

In the 25 years since you co-founded Partners in Health, what have been some of the more positive changes you’ve witnessed, in terms of education and health care, particularly for girls?

Over the past 25 years, I have seen many positive developments in health care and education. Certainly we have seen many setbacks as well, but many positive developments. For example, in Haiti, what struck me as a physician-in-training was the lack of medical care. I also learned that by investing in education you improve health status quite directly. One of the most positive things I have seen in the many years of working in Haiti is the impressive return of investing 25 years in the same area, making sure that people are getting basic health care and education – not as something they have to scramble for, but rather as a basic safety net of services.

One of the most impressive things that I have seen over the past decade has been in Rwanda. I went there several years after the genocide in response to an invitation from Rwandan colleagues and others – including President Clinton– to work on building up the health care infrastructure. By that time there had been real commitments to gender equity codified in Rwandan social life. It naturally helped that some of this came from the top down, such as gender parity on representation in parliament. Rwanda has more women leaders than any other parliament in the world now, and that is not by accident. It is because people actually said that gender equity is worth fighting for at that level. If girls are not in school, your future political leaders are not available – and neither are your future business leaders, and the leaders of all life in a society. If you do not educate girls you are losing out on half, and some would argue more than half, of your society’s potential.

How does education help promote gender equality?

Without investments in education we cannot achieve gender equality or meet any kind of development goals. It is no accident that the settings in which girls’ education has been invested in heavily are those that have better development and economic indices. So if we really want to promote development, development of human capital, we need to have certain priorities. The top of that list needs to be equity investments in girls’ education.

It is also important to note that in many very poor societies parents are committed to educating their children. Haiti is a very complex society – as is true of any society – but the numbers show that families living in poverty are willing to invest very large fractions of all their disposable income into education. So that is what we need to build in the world: a system for primary education so that everybody on the planet can go to primary school and beyond. But we must acknowledge that the equity question – particularly around poor girls’ education – is critical. There are places in the world where it is just around girls’ education, but in fact it is mostly around the intersection of poverty and gender inequality. While if we focus on girls we focus on half the planet, if we focus on girls living in poverty and their families, and open some doors for those families, I think we will see that most families do want their girls educated. At least that is what I have seen in Haiti, Rwanda and elsewhere in the world.

In your experience, what happens to a girl or boy who does not receive an education?

When girls are not educated, eventually by and large mothers will not be educated. And when mothers are not educated, they often live in poverty. And when they live in poverty, their children are vulnerable to all sorts of illnesses, including easily preventable ones. So the downside of not having girls’ education is enormous. And we lack even the proper metrics to assess what we have lost by failing to invest equitably in girls’ education.

In Haiti, since the earthquake, I have seen so much suffering – as has everybody who works there – that was just unnecessary. Every case of tetanus, many of them fatal, means that someone did not have a vaccination, a very simple and inexpensive vaccination. Is that the fault of young women who are not well trained and did not go to school? No. It is part of a system that does not make it easy for young people to access healthcare, preventative services, but also again it is girls’ education. Because we know already that the children most likely to receive the public health benefits are those whose mothers have gone through some formal schooling.

Is there anything else about education and your work that you would like to add?

I will give you three justifications for girls’ education: 1) you will never break the cycle of poverty or disease without educating girls. It won’t happen. So that is a development justification for girls’ education; 2) you won’t see economic growth unless girls are educated. So that’s a growth justification; 3) the third justification – the rights-based argument – is one that I think we forget too often, because it is very difficult to lend real implementation teeth to rights-based arguments.

But whether you look at rights, growth, or economic development with equity, you still need to invest in girls’ education. So as Americans say, it is a ‘no brainer’. We are not going to move forward – whether as a series of nations or a global community – until we have substantial investments in girls’ education.